Nov 6 (Reuters) - Express Scripts Holding Co on
Tuesday said its business of managing pharmacy benefits for
large employers will come under pressure next year in the weak
economy, but investors questioned whether the company's own
strategy was on track.

Shares of Express Scripts, which became the largest U.S.
pharmacy benefits manager after buying rival Medco Health
Solutions earlier this year, fell 11 percent, a day after the
company warned that Wall Street's 2013 forecasts were too
aggressive.

Company executives, in a conference call on Tuesday that was
punctuated by heated exchanges with industry analysts, tried to
explain their view.

"Large employers have pulled back on hiring plans, using
contractors and part-time employees when necessary. Mid- and
small employers are cutting back on healthcare decisions while
waiting for more clarity on healthcare reform," Chief Executive
George Paz said during the call.

"And we continue to see low rates of drug utilization as
individuals deal with uncertainty at the household level," Paz
said, referring to a cutback on spending by Americans as they
worry about their job security.

Analysts asked Express Scripts to reconcile its view with
that of other industry sources who expect an increase in drug
use next year that would benefit the sector as a whole.
Continued...